Reflex: October 18, 2011

Medicare has begun to release patient safety ratings for hospitals, reports Jordan Rau. “The new data, available starting last week on Medicare’s Hospital Compare website, evaluate hospitals on how often their patients suffer complications such as a collapsed lung, a blood clot after surgery or an accidental cut or tear during treatment.” These ratings will be used to help decide which hospitals will win and lose under new programs of reimbursement. Aaron’s commentPredictably, hospitals that treat sicker patients or do more surgeries are concerned that they look worse than hospitals that have it easier. Although the ratings try to take sickness levels into account in the ratings, they’re not perfect, and may make some hospitals look worse than they are.

Massachusetts considers “global payments” to rein in health spending, reports Abby Goodnough and Kevin Sack (NYT). “[T]he state’s legislative leaders appear close to producing bills that would make Massachusetts the first state — again — to radically revamp the way doctors, hospitals and other health providers are paid. Although important details remain to be negotiated, the legislative leaders and Gov. Deval Patrick, all Democrats, are working toward a plan that would encourage flat ‘global payments’ to networks of providers for keeping patients well, replacing the fee-for-service system that creates incentives for excessive care by paying for each visit and procedure.” Austin’s comment: This is a well-reported article and worth a full read. I don’t have anything to add. 

Obama doesn’t want CLASS repealed, reports Julian Pecquet. The White House says that instead of repealing CLASS, both parties should be working on ways to improve the LTC system. Don’s comment: The problems with CLASS are not mysterious, but are related to needing to ensure that healthy persons sign up (via expanded definitions of work that would be required to do so, and likely a simple one-time underwriting test), the need for aggressive enrollment procedures/marketing, and perhaps a change in the benefit structure. These are big changes and cannot be undertaken administratively, but would require new legislation. Here are a few ideas on changes, and a more straightforward policy is needed as the lack of a coherent LTC system pops up throughout the health care system, such as in Medicare hospice policy. The White House seems to be interested in moving ahead on this, but that seems unlikely from a political standpoint. h/t Wonkbook.

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